BURN2: The Burn Ward
(C)1991 Alan M. Schwartz
When last we had left our intrepid chemist, he had flash
vaporized the skin of his upper torso, face and hands in a Class
D chemical fireball. After being hauled into the Emergency Room
where the doctors got to use drugs and equipment normally
reserved for hostile government interrogations, his still smoking
but stubbornly vital remains were wheeled to The Burn Ward. Our
story continues.
The Burn Ward is a placid refuge at 4 am. The nurses are in the
nurses' station munching on candy bars and counting the holes in
the acoustic tile. The patients are in their beds floating on
within a bower of chemical enchantment. All is quiet except for
the lump in the corner who tried to punch out by dousing himself
with gasoline and flicking his Bic. With more than 90% of his
surface cooked off and his lungs seared to mush, he lies
twitching in the corner, hooked to a noisy respirator, surrounded
by an electronic cacophony visibly and audibly reporting his
moment to moment survival. He would be kept alive for another
annoying week, four in all, before his remains irreversibly
terminated.
They eased me into my berth, hooked up a bunch of stuff that was
mercifully silent, hooked up more stuff, hooked up more stuff,
and departed. Over the first three days of my two week stay in
Intensive Care/Burns, I was to receive more than 40 pounds of IV
juice. More than 16 bags piggybacked through a bank of four
peristaltic pumps, whirred away night and day because burned skin
does not hold in fluid, and hypovolemic shock (or electrolyte
imbalance, or osmotic shock, or...) kills. I mentally drifted
for three hours, riding the first four pages of my 26 page
pharmaceutical bill, and morning struck.
"How bad can it be?" I thought. The situation was grimly
painful, but the morphine, tranquilizers, histamine receptor
blockers, and burn cream took the edge off. A nurse came over,
did morning things, and told me I was scheduled for Hydrotherapy
in an hour. They were going to unwrap everything, soak me in a
Jacuzzi for a while, scrape off exudate and dead tissue with a
stainless steel windshield wiper, rewrap the remains, and we
would proceed from there. "YOU'RE GONNA DO WHAT!"
They wheeled my equipment and me into a large room with very
thick doors (you'll see) and unwrapped everything. Now there
was a bit of basic mind-consuming and infinitely prolonged
agony. They maneuvered me into a steel tub filled with bubbly
medicated water, which was not so bad. They washed me down much
in the manner of Thai bathhouses featured during ratings week on
TV, which was not so bad. They shot 10mg of morphine sulfate
into my IV line, which was not bad at all. They took a 304 SS
debridement tool, a little piece of gray steel about three inches
long, and started scraping off the eschar -- dead tissue, crusted
exudate, and yellow adherent gooey stuff. The worst part is the
start, when your entire mind is demolished in a violent frenzy of
escape. This is nothing. It gets worse and worse, the torment
spiraling into infinity, finding no lack of new and blistering
anguish to blast through your skull. They start on your fingers,
blackened nails and hanging shreds of char, and you scream.
Screaming is generally viewed as being in poor taste, putting the
other patients off their feed and perhaps distressing the annual
budget when an even thicker door for the Hydrotherapy Room must
be requisitioned. You get a pause, a swig of cold fruit juice,
and they continue. You quiver and hyperventilate, your eyes
bulge from their sockets, your tongue swells, and you scream.
Tummy, chest, neck, face, ears, arms, hands and fingers are all
scraped down to clean, raw living tissue. It makes for a long 90
minutes.
Let us interject a heartfelt round of applause for Adrian, Beth,
and Sarah and their staff who scraped me for two weeks running,
without compromise or oversight. Everything healed neatly and
mostly unsullied, a happy ending well beyond the medical
community's initial expectations.
When clean, pink and pretty you finally exit that tub, the dozens
of gallons of water rich with biological debris and thick with
floating clots of your dead hide, the cold air hits and you are
naked in an Arctic blizzard. MacDonalds has no difficulty
keeping its burgers warm, but a major metropolitan hospital
cannot be so bothered, letting the burn patients goddamn freeze!
The world is a glacial misery when you have no skin! Anyway,
they cover you with creamed gauze, slap on more burn cream by the
handful, wrap you with mesh, and haul your sorry carcass back to
the ward for a quiet day of opiates, tranquilizers, and all the
juice and food you can pound down.
This was Sunday. While the coming week(s) extrapolated as being
possessed of limited recreational desirability, how much worse
could it get?
The very next day I learned how to eat 7000 Calories the hard
way, and the special significance of Monday Mini-Rounds.
Hydrotherapy was beyond belief. Hydrotherapy on Monday was
beyond astonishment. The saga continues...